Understanding Which age group is most vulnerable during cold waves?

October 1, 2025 •

5 min read

According to the National Institute on Aging, older adults have a higher chance of being affected by cold weather due to physiological changes. When considering which age group is most vulnerable during cold waves, both the very young and the elderly face significant risks because their bodies are less capable of regulating core temperature effectively.

Quick Summary

The very young, particularly infants, and older adults aged 65 and above are the most vulnerable populations during cold waves due to compromised thermal regulation. This guide details the specific risks for each group, provides a side-by-side comparison, and outlines critical preventative strategies to ensure their safety from cold-related illnesses.

Key Points

Older Adults Most Vulnerable: Adults 65 and older are at high risk due to reduced metabolic function, less body fat, and decreased awareness of temperature changes.
Infants Face Unique Risks: Babies, especially newborns, are susceptible because their thermoregulation systems are immature, and they lose heat more rapidly due to their body size.
Pre-existing Conditions Worsened by Cold: Chronic illnesses like diabetes, heart disease, and arthritis increase cold sensitivity and risk in older adults.
Medication Interference: Certain medications can impair the body's ability to regulate temperature, putting older individuals at greater risk of hypothermia.
Layering is Key for Both Groups: For older adults, layers help trap body heat. For infants, one more layer than an adult provides necessary warmth.
Recognize Hypothermia Signs: Be alert for cognitive changes like confusion in older adults and low energy in infants, as shivering may be absent in advanced hypothermia.
Safe Indoor Heating is Critical: Ensure indoor temperatures are maintained above 68°F for older adults, and avoid overheating infants. Use safe heating methods.

Who is most vulnerable during a cold wave?

Cold waves pose a significant health threat to the general population, but their impact is not felt equally. While anyone can suffer from cold-related illnesses, specific age groups are at a much higher risk due to a combination of physiological, social, and environmental factors. The two most vulnerable demographics are older adults and infants/young children. Understanding the specific reasons for their vulnerability is the first step toward effective protection.

Older Adults (65+)

As the body ages, its ability to thermoregulate—or maintain a stable internal temperature—declines. This makes older adults particularly susceptible to cold-related injuries and conditions.

Reduced Metabolic Rate: The body’s metabolism slows with age, generating less heat internally.
Less Body Fat: The layer of insulating fat beneath the skin thins with age, reducing the body's natural defense against cold.
Impaired Circulation: Blood flow to the extremities can decrease, especially in older adults with conditions like diabetes or cardiovascular disease, putting them at higher risk for frostbite.
Chronic Health Conditions: Pre-existing conditions such as arthritis, diabetes, and thyroid problems can be exacerbated by cold and interfere with the body's ability to stay warm.
Medication Side Effects: Some medications commonly used by older adults, including certain antidepressants and heart medications, can affect the body's temperature regulation or impair judgment.
Reduced Awareness: Older adults may not perceive changes in temperature as readily as younger individuals, meaning they may not realize they are becoming dangerously cold until it's too late.

Infants and Young Children

At the other end of the age spectrum, infants and very young children are also highly vulnerable during cold waves. Their small bodies are not yet equipped to handle extreme temperatures efficiently.

Immature Temperature Regulation: A baby's temperature control system is not fully developed. They cannot shiver effectively to generate heat, and their bodies do not conserve heat as well as adults'.
Higher Surface Area-to-Weight Ratio: Infants have a larger body surface area relative to their weight, causing them to lose body heat much more rapidly.
Limited Communication: Unlike adults, infants cannot vocalize or signal that they are too cold. Their discomfort may only be apparent through subtle signs like fussiness or decreased energy.
Dependence on Caregivers: Infants are completely reliant on their caregivers to provide a safe, warm environment and appropriate clothing.

Other At-Risk Populations

Beyond age, several other factors can increase a person's vulnerability to cold weather.

People experiencing homelessness: Lack of adequate shelter, clothing, and nutrition makes this group extremely vulnerable.
Outdoor workers: Those with occupations in construction, farming, or other outdoor jobs have prolonged exposure to cold elements.
People with chronic illnesses: Conditions like respiratory or cardiovascular diseases can be worsened by cold air.
Individuals with mental health issues: Those with cognitive impairment or mental health conditions may struggle to take proper precautions.

Vulnerability Comparison: Older Adults vs. Infants


Feature	Older Adults (65+)	Infants and Young Children	Middle-Aged Adults (for context)
Physiological Response	Slowed metabolism, less body fat, and decreased circulation reduce heat generation and retention.	Immature temperature regulation, lack of shivering response, and large surface area-to-weight ratio cause rapid heat loss.	Developed and efficient thermoregulatory systems, with functional shivering to produce heat.
Chronic Illness Influence	Pre-existing conditions like diabetes and heart disease significantly increase risk.	Generally healthy with a developing immune system; risks relate more to viral infections thriving in cold weather.	Typically lower risk unless they have a pre-existing medical condition.
Medication Impact	Many medications can affect temperature regulation and judgment.	Generally not a factor, but special care is needed if medication is required.	Less common unless they are on specific medications.
Communication of Discomfort	May have reduced awareness of cold or cognitive issues preventing communication.	Cannot communicate discomfort or needs effectively.	Capable of clearly communicating if they are too cold.
Mobility	Increased risk of falls on icy surfaces; arthritis can reduce mobility.	Lack of mobility means they cannot move to a warmer location on their own.	Typically mobile and able to move out of the cold.

Recognizing and Responding to Cold-Related Risks

Understanding the signs of cold-related illnesses is crucial for protecting vulnerable individuals. The symptoms can be subtle and differ between age groups.

Hypothermia Symptoms in Vulnerable Groups

Older Adults: Confusion, memory loss, slurred speech, drowsiness, and a puffy or swollen face. Shivering may be minimal or absent.
Infants: Cold, red, and firm skin, with unusually low energy levels or decreased attentiveness.

Frostbite Warning Signs

Redness or pain in the skin, which progresses to a white or grayish-yellow appearance.
Skin that feels unusually firm or waxy.
Numbness in the affected area, which is most common in extremities like fingers, toes, and ears.

Protecting Vulnerable Age Groups

Prevention is the most effective strategy for managing cold wave risks. Here are some tailored tips for each group.

For Older Adults

Maintain Indoor Temperature: Keep the thermostat set to at least 68°F (20°C). Even mildly cool homes can be dangerous.
Dress in Layers: Wear loose-fitting, layered clothing to trap heat effectively. Wear socks and slippers even when indoors.
Stay Hydrated and Nourished: Drink warm, non-caffeinated beverages and eat regular, warm meals to help maintain body heat.
Limit Outdoor Exposure: Avoid unnecessary outings during extreme cold. If venturing out, wear appropriate warm clothing, including a hat, scarf, and gloves.
Ensure Safety: Have a plan for power outages and check on older neighbors or family members regularly.

For Infants and Young Children

Dress in Layers: Follow the rule of thumb: one more layer than an adult would wear. Include a hat, mittens, and warm booties.
Use Car Seats Safely: Never put a child in a puffy coat in a car seat, as this can compress and compromise safety in a crash. Instead, use thin layers and place a blanket over the harness.
Limit Time Outdoors: Minimize exposure to extreme cold and wind, especially for newborns. Keep outings brief and check for signs of cold.
Ensure Warm Bedding: Use a sleep sack or wearable blanket instead of loose blankets, which pose a SIDS risk. Ensure the crib is not near a window or draft.

Conclusion

While a cold wave can pose dangers to anyone, older adults and infants are undeniably the most vulnerable populations due to distinct physiological factors. Older adults face challenges from a decreased ability to regulate body heat and manage pre-existing conditions, while infants have an immature thermoregulatory system and higher heat loss. Protecting these groups requires a combination of vigilance, preventative measures, and community awareness. By understanding the specific risks and implementing the right precautions, we can significantly reduce the risk of cold-related illness and ensure the safety of our most susceptible community members.

Authority Link

For more detailed information on cold weather safety for older adults, visit the National Institute on Aging: https://www.nia.nih.gov/health/safety/cold-weather-safety-older-adults

Frequently Asked Questions

Older adults are vulnerable because their bodies lose heat faster and produce less heat due to a slower metabolism, less body fat, and reduced circulation. Chronic conditions and certain medications can also interfere with temperature regulation.

Infants are at risk because their bodies have a higher surface area-to-weight ratio and an immature temperature regulation system, which causes them to lose heat more quickly. They also cannot communicate when they are too cold.

In older adults, shivering can be minimal or absent during hypothermia. Key signs to watch for include confusion, memory loss, slurred speech, drowsiness, and a puffy or swollen face. Pale skin and a weak pulse are also indicators.

The American Academy of Pediatrics recommends dressing a baby in one more layer of clothing than an adult would wear. Layering allows for easy adjustments when moving between indoor and outdoor spaces. A hat, mittens, and warm booties are also essential.

Puffy coats can create a dangerous gap between the baby and the car seat harness. In a crash, the material can compress, leaving the baby unsecured. Use thin layers and place a blanket over the buckled harness instead.

If you suspect someone has hypothermia, move them to a warm place, remove any wet clothing, and wrap them in dry blankets. Call 911 immediately. Offer warm (not hot), non-alcoholic, non-caffeinated drinks if they are conscious.

While not a specific age group, homeless individuals are among the most vulnerable during cold waves due to a lack of shelter, proper heating, and protective clothing. They face a severe, life-threatening risk of hypothermia and frostbite.